Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics

Detalhes bibliográficos
Autor(a) principal: Franco-Luiz, Ana Paula Moreira
Data de Publicação: 2023
Outros Autores: Fernandes, Nubia Monteiro Gonçalves Soares, Silva, Thais Bárbara de Souza, Bernardes, Wilma Patrícia de Oliveira Santos, Westin, Mateus Rodrigues, Santos, Thais Garcia, Fernandes, Gabriel da Rocha, Simões, Taynãna César, Silva, Eduardo Fernandes E, Gava, Sandra Grossi, Alves, Breno Magalhães, Melo, Mariana de Carvalho, Pereira, Rosiane Aparecida da Silva, Alves, Pedro Augusto, Fonseca, Cristina Toscano
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/60125
Resumo: Introduction: The pandemic caused by SARS-CoV-2 has had a major impact on health systems. Vaccines have been shown to be effective in improving the clinical outcome of COVID-19, but they are not able to fully prevent infection and reinfection, especially that caused by new variants. Methods: Here, we tracked for 450 days the humoral immune response and reinfection in 52 healthcare workers from Brazil. Infection and reinfection were confirmed by RT-qPCR, while IgM and IgG antibody levels were monitored by rapid test. Results: Of the 52 participants, 19 (36%) got reinfected during the follow-up period, all presenting mild symptoms. For all participants, IgM levels dropped sharply, with over 47% of them becoming seronegative by the 60th day. For IgG, 90% of the participants became seropositive within the first 30 days of follow-up. IgG antibodies also dropped after this period reaching the lowest level on day 270 (68.5 ± 72.3, p<0.0001). Booster dose and reinfection increased the levels of both antibodies, with the interaction between them resulting in an increase in IgG levels of 130.3 arbitrary units. Conclusions: Overall, our data indicate that acquired humoral immunity declines over time and suggests that IgM and IgG antibody levels are not associated with the prevention of reinfection.
id CRUZ_07d35e11438da8931937952d72f66009
oai_identifier_str oai:www.arca.fiocruz.br:icict/60125
network_acronym_str CRUZ
network_name_str Repositório Institucional da FIOCRUZ (ARCA)
repository_id_str 2135
spelling Franco-Luiz, Ana Paula MoreiraFernandes, Nubia Monteiro Gonçalves SoaresSilva, Thais Bárbara de SouzaBernardes, Wilma Patrícia de Oliveira SantosWestin, Mateus RodriguesSantos, Thais GarciaFernandes, Gabriel da RochaSimões, Taynãna CésarSilva, Eduardo Fernandes EGava, Sandra GrossiAlves, Breno MagalhãesMelo, Mariana de CarvalhoPereira, Rosiane Aparecida da SilvaAlves, Pedro AugustoFonseca, Cristina Toscano2023-08-16T19:41:45Z2023-08-16T19:41:45Z2023FRANCO-LUIZ, Ana Paula Moreira et al. Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics. Front Immunol, v. 14, p. 1220600, 2023. doi.org/10.3389/fimmu.2023.1220600.1664-3224https://www.arca.fiocruz.br/handle/icict/60125engFrontiers Research FoundationLongitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamicsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleIntroduction: The pandemic caused by SARS-CoV-2 has had a major impact on health systems. Vaccines have been shown to be effective in improving the clinical outcome of COVID-19, but they are not able to fully prevent infection and reinfection, especially that caused by new variants. Methods: Here, we tracked for 450 days the humoral immune response and reinfection in 52 healthcare workers from Brazil. Infection and reinfection were confirmed by RT-qPCR, while IgM and IgG antibody levels were monitored by rapid test. Results: Of the 52 participants, 19 (36%) got reinfected during the follow-up period, all presenting mild symptoms. For all participants, IgM levels dropped sharply, with over 47% of them becoming seronegative by the 60th day. For IgG, 90% of the participants became seropositive within the first 30 days of follow-up. IgG antibodies also dropped after this period reaching the lowest level on day 270 (68.5 ± 72.3, p<0.0001). Booster dose and reinfection increased the levels of both antibodies, with the interaction between them resulting in an increase in IgG levels of 130.3 arbitrary units. Conclusions: Overall, our data indicate that acquired humoral immunity declines over time and suggests that IgM and IgG antibody levels are not associated with the prevention of reinfection.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Imunologia de Doenças Virais. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Informática de Biossistemas. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Serviço de capacitação em métodos quantitativos. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Helmintologia e Malacologia Médica. Belo Horizonte, MG, Brazil.Prefeitura de Belo Horizonte. Hospital Doutor Célio de Castro. Centro de Vigilância em Saúde e Segurança do Paciente. Belo Horizonte, MG, Brazil.Prefeitura de Belo Horizonte. Hospital Doutor Célio de Castro. Serviço Especializado em Segurança e Medicina do Trabalho. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Imunologia de Doenças Virais. Belo Horizonte, MG, Brazil.Fundação Oswaldo Cruz Instituto René Rachou. Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias. BeloCOVID-19SARS-COV-2antibodyhealthcare workershumoral immunityreinfectioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/60125/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALlongitudinal study.pdflongitudinal study.pdfapplication/pdf4331315https://www.arca.fiocruz.br/bitstream/icict/60125/2/longitudinal%20study.pdfd7870de7503e5f99f22ec55ffa3f77aaMD52icict/601252023-08-16 16:41:46.451oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-08-16T19:41:46Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.en_US.fl_str_mv Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
title Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
spellingShingle Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
Franco-Luiz, Ana Paula Moreira
COVID-19
SARS-COV-2
antibody
healthcare workers
humoral immunity
reinfection
title_short Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
title_full Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
title_fullStr Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
title_full_unstemmed Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
title_sort Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics
author Franco-Luiz, Ana Paula Moreira
author_facet Franco-Luiz, Ana Paula Moreira
Fernandes, Nubia Monteiro Gonçalves Soares
Silva, Thais Bárbara de Souza
Bernardes, Wilma Patrícia de Oliveira Santos
Westin, Mateus Rodrigues
Santos, Thais Garcia
Fernandes, Gabriel da Rocha
Simões, Taynãna César
Silva, Eduardo Fernandes E
Gava, Sandra Grossi
Alves, Breno Magalhães
Melo, Mariana de Carvalho
Pereira, Rosiane Aparecida da Silva
Alves, Pedro Augusto
Fonseca, Cristina Toscano
author_role author
author2 Fernandes, Nubia Monteiro Gonçalves Soares
Silva, Thais Bárbara de Souza
Bernardes, Wilma Patrícia de Oliveira Santos
Westin, Mateus Rodrigues
Santos, Thais Garcia
Fernandes, Gabriel da Rocha
Simões, Taynãna César
Silva, Eduardo Fernandes E
Gava, Sandra Grossi
Alves, Breno Magalhães
Melo, Mariana de Carvalho
Pereira, Rosiane Aparecida da Silva
Alves, Pedro Augusto
Fonseca, Cristina Toscano
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Franco-Luiz, Ana Paula Moreira
Fernandes, Nubia Monteiro Gonçalves Soares
Silva, Thais Bárbara de Souza
Bernardes, Wilma Patrícia de Oliveira Santos
Westin, Mateus Rodrigues
Santos, Thais Garcia
Fernandes, Gabriel da Rocha
Simões, Taynãna César
Silva, Eduardo Fernandes E
Gava, Sandra Grossi
Alves, Breno Magalhães
Melo, Mariana de Carvalho
Pereira, Rosiane Aparecida da Silva
Alves, Pedro Augusto
Fonseca, Cristina Toscano
dc.subject.en.en_US.fl_str_mv COVID-19
SARS-COV-2
antibody
healthcare workers
humoral immunity
reinfection
topic COVID-19
SARS-COV-2
antibody
healthcare workers
humoral immunity
reinfection
description Introduction: The pandemic caused by SARS-CoV-2 has had a major impact on health systems. Vaccines have been shown to be effective in improving the clinical outcome of COVID-19, but they are not able to fully prevent infection and reinfection, especially that caused by new variants. Methods: Here, we tracked for 450 days the humoral immune response and reinfection in 52 healthcare workers from Brazil. Infection and reinfection were confirmed by RT-qPCR, while IgM and IgG antibody levels were monitored by rapid test. Results: Of the 52 participants, 19 (36%) got reinfected during the follow-up period, all presenting mild symptoms. For all participants, IgM levels dropped sharply, with over 47% of them becoming seronegative by the 60th day. For IgG, 90% of the participants became seropositive within the first 30 days of follow-up. IgG antibodies also dropped after this period reaching the lowest level on day 270 (68.5 ± 72.3, p<0.0001). Booster dose and reinfection increased the levels of both antibodies, with the interaction between them resulting in an increase in IgG levels of 130.3 arbitrary units. Conclusions: Overall, our data indicate that acquired humoral immunity declines over time and suggests that IgM and IgG antibody levels are not associated with the prevention of reinfection.
publishDate 2023
dc.date.accessioned.fl_str_mv 2023-08-16T19:41:45Z
dc.date.available.fl_str_mv 2023-08-16T19:41:45Z
dc.date.issued.fl_str_mv 2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv FRANCO-LUIZ, Ana Paula Moreira et al. Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics. Front Immunol, v. 14, p. 1220600, 2023. doi.org/10.3389/fimmu.2023.1220600.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/60125
dc.identifier.issn.en_US.fl_str_mv 1664-3224
identifier_str_mv FRANCO-LUIZ, Ana Paula Moreira et al. Longitudinal study of humoral immunity against SARS-CoV-2 of health professionals in Brazil: the impact of booster dose and reinfection on antibody dynamics. Front Immunol, v. 14, p. 1220600, 2023. doi.org/10.3389/fimmu.2023.1220600.
1664-3224
url https://www.arca.fiocruz.br/handle/icict/60125
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Frontiers Research Foundation
publisher.none.fl_str_mv Frontiers Research Foundation
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/60125/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/60125/2/longitudinal%20study.pdf
bitstream.checksum.fl_str_mv 5a560609d32a3863062d77ff32785d58
d7870de7503e5f99f22ec55ffa3f77aa
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
_version_ 1798324896711835648